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Medicaid eligibility changes will impact all Medicaid recipients. Stay informed!

On April 1, 2023, Pennsylvania ended continuous coverage for Medicaid recipients. Medicaid is also known as Medical Assistance or MA in Pennsylvania. The continuous coverage requirement was initially put in place because of the national Public Health Emergency related to COVID-19.

UPMC for You wants to share information to help our members stay informed about this change. If you are a UPMC for You member, you should take the following steps to renew your Medicaid coverage after the continuous coverage requirement ends.

What is continuous coverage?

The continuous coverage requirement has allowed Medicaid members to keep their health care benefits even if they would have otherwise been disenrolled from the program based on their income or other factors.

What happens now?

When the continuous coverage requirement ends, the Pennsylvania Department of Human Services (DHS) must determine if Medicaid recipients are still eligible for coverage over the next year. Recipients will have to complete renewal each year to learn if they can keep their coverage.

How can Medicaid recipients prepare?

Medicaid recipients should verify their current contact information with DHS and update it if it has changed. This will help ensure that they receive their renewal packet and other important information.

Recipients can use one of these methods to update their address, phone number, or email address.

  • Log in to their My COMPASS Account.
  • Use the free myCOMPASS PA mobile app.
  • Call 1-877-395-8930. Help is available Monday through Friday from 8 a.m. to 4:30 p.m. Those who are in Philadelphia should call 215-560-7226.

When is the renewal due?

Renewals should be completed when they are received.

Each person’s renewal date is unique to them. Recipients will get a renewal packet in the mail at some point during the year. Information about the renewal will start to arrive 90 days before it is due and recipients can check their renewal date at dhs.pa.gov/COMPASS or on the myCOMPASS PA mobile app.

It is very important for recipients to complete and return their renewal forms, even if nothing has changed.

DHS will use the renewal forms to determine who is eligible to keep their Medicaid coverage. If you don’t think you’ll be eligible anymore, completing the renewal will make sure you’re connected to affordable health coverage quickly.

There are a few ways for Medicaid recipients to complete their renewal:

  • By mail. Recipients can complete their forms and mail them back in the envelope that is included in the packet.
  • In person. Recipients can turn in their completed forms at the local County Assistance Office (CAO).
  • On the web. Recipients can complete their renewal online at dhs.pa.gov/COMPASS.
  • By phone. Recipients can complete the renewal by calling 1-866-550-4355 (TTY: 1-877-202-3021).

What will happen after DHS reviews a recipient’s completed renewal?

For people who are still eligible for Medicaid coverage but did not complete their renewal correctly, DHS will provide instructions on how to re-enroll. 

Those who are not eligible will have their information securely transferred to Pennie®, Pennsylvania’s official health insurance marketplace, where one can select a qualified health plan (QHP) that best fits your needs. 

There, UPMC has low-cost or even no-cost plans to choose from, and Pennie may be able to connect you with financial savings to help reduce the cost of coverage and care. More on Pennie is available at pennie.com.

Visit www.dhs.pa.gov/PHE to stay up to date on DHS information. The website includes frequently asked questions, videos, webinars, and more.